No office rate
40701 is for primary bilateral repair. This code is for secondary repair in infancy after an earlier cleft repair.
On this page
CMS RVU26D · Effective 2026-10-01
40702 Cleft lip repair Medicare reimbursement rates in Minnesota
Reports secondary surgical repair of a bilateral cleft lip and associated nasal deformity in an infant, rather than primary repair or later revision. Compare 40702 office and facility rates across CMS payment localities in Minnesota.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 40702 in Minnesota?
Minnesota has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$848.93
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Plastic surgery
About 40702: Secondary bilateral cleft lip repair in infancy
Reports secondary surgical repair of a bilateral cleft lip and associated nasal deformity in an infant, rather than primary repair or later revision.
This code describes secondary repair of a bilateral cleft lip and associated nasal deformity in infancy, before age four. A plastic, craniofacial, or other appropriately trained surgeon typically performs the reconstruction in an operating room, often at a children’s hospital. The service addresses residual deformity after an earlier repair; it is distinct from the initial repair of the cleft.
Select the code based on the secondary nature of the operation, the patient’s age, and bilateral involvement. The operative report should establish the prior repair and describe the lip and nasal deformities treated. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. The code is priced bilaterally, so modifier 50 does not increase payment. Assistant-at-surgery payment may be made; co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 40702
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.91 · 52%
- Practice expense (office) RVU10.44 · 39%
- Malpractice RVU2.58 · 10%
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
40702 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
40700 describes primary unilateral repair; this code describes secondary bilateral repair in infancy.
No office rate
Both describe secondary repair, but 40720 is for an older child or adult; this code is for infancy.
Compare 40702 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Minnesota →
Office / nonfacility
Unavailable
Facility
$848.93
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 40702 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
4,848
- Code
- 40702
- Physician work
- 13.91
- Practice expense
- 10.44
- Malpractice
- 2.58
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.91 | × 1.000 | 13.9100 |
| Practice expense | 10.44 | × 1.029 | 10.7428 |
| Malpractice | 2.58 | × 0.296 | 0.7637 |
| Total RVUs | 25.4164 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$848.93
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.91 | 1 |
| Practice expense | 10.44 | 1.029 |
| Malpractice | 2.58 | 0.296 |
(13.91 × 1 + 10.44 × 1.029 + 2.58 × 0.296) × $33.4009 = $848.93
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
40702 billing questions
When should this code be chosen instead of 40701?
Use this code for secondary repair in infancy. Code 40701 describes primary bilateral repair, not revision after an earlier repair.
Should modifier 50 be appended for bilateral repair?
The code is already priced as bilateral. Modifier 50 does not increase its payment.
Does the global period include related postoperative care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be made. CMS does not permit co-surgeon or team-surgery payment for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,8454069F,,Vte prophylaxis rcvd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,84640700,,Repair cleft lip/nasal,A,,13.82,10.90,NA,10.90,,2.57,27.29,27.29,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,84740701,,Repair cleft lip/nasal,A,,16.80,11.98,NA,11.98,,3.11,31.89,31.89,0,090,0.09,0.81,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,84840702,,Repair cleft lip/nasal,A,,13.91,10.44,NA,10.44,,2.58,26.93,26.93,0,090,0.09,0.81,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,8494070F,,Dvt prophylx recvd day 2,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,85040720,,Repair cleft lip/nasal,A,,14.35,10.60,NA,10.60,,2.67,27.62,27.62,0,090,0.09,0.81,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,8514073F,,Oral antiplat thx rx dischrg,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002